老年常见慢性病患者基本药物使用分析

Analysis of essential medicines use in elderly patients with common chronic disease

目的了解国家基本药物目录在老年常见慢性病患者中使用的适用性,为加强国家基本药物使用管理、遴选以及完善政策提供参考。方法对中国7地区15家不同等级医疗机构中患有慢性病的老年患者开展问卷调研,了解老年常见慢性病患者的基本信息、疾病信息以及用药清单等资料,对数据进行统计分析。结果共回收有效问卷1053份,患者平均患病种数为2.8种,共使用药品3952例次,平均每人使用3.8种,其中使用基本药物2761例次(69.9%,2761/3952),使用至少1种基本药物例数占总例数的92.6%(975/1053)。患者使用例次较高的药物主要包括抗血小板药、降糖药、降压药和调脂药;排名前10位的药品分别为阿司匹林、阿托伐他汀、二甲双胍、美托洛尔、氨氯地平、硝苯地平、瑞舒伐他汀、氯吡格雷、阿卡波糖和胰岛素,绝大多数为国家基本药物目录品种。结论国家基本药物目录药品在老年患者中使用比例较高,是其治疗药物管理中的核心药物,加强国家基本药物的遴选、动态调整和使用管理对安全、有效、合理、经济用药具有重大意义。

Objective To assess the applicability of the national essential medicines list in elderly patients with common chronic diseases,providing a reference for strengthening the management of essential medicines,selecting national essential medicines,and improving relevant policies.Methods The survey was conducted among elderly patients with common chronic diseases in 15 medical institutions of different levels in 7 regions of China,aimed at gathering basic information,disease information and medication lists of elderly patients with common chronic diseases,followed by statistical analysis of the collected data.Results A total of 1053 valid questionnaires were collected with an average of 2.8 diseases per patient.There were 3952 instances of medication use,averaging 3.8 medications per person.Among these,basic medications were used in 2761 instances(69.9%,2761/3952),and the proportion of patients who used at least one essential drug was 92.6%(975/1053).Drugs with the highest frequency of use mainly included antiplatelet drugs,hypoglycemic drugs,antihypertensive drugs,and lipid-adjusting drugs.The top 10 drugs in the ranking were aspirin,atorvastatin,metformin,metoprolol,amlodipine,nifedipine,rosuvastatin,clopidogrel,acarbose,and insulin,most of which were listed as national essential medicines.Conclusion The utilization rate of national essential medicine use among elderly patients was relatively high,and they are the core drugs in medication therapy management for the elderly.Strengthening the selection,dynamic adjustment and use of essential medicines is of great significance to clinical safety,effectiveness,rationality and economical use.